Reach Out and Read Blog

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Wednesday June 14, 2017

Extending our program to the first few months in
accordance with research demonstrating the importance of the first
few months to a child's foundation for success.

A guest blog from Teandra Ramos-Hardy, MSW, Director of Medical
Engagement for Reach Out and Read Carolinas

We know from research that brains are built over
time through a process that begins prenatally.
The Center on the Developing Child at Harvard University has an
abundance of research confirming that the foundation for all future
learning is shaped by early experiences, beginning at birth.
A brain's architecture does not grow in isolation; it is developed
by interactions with both genes and experiences. The early
years are the most active period for establishing neural
connections in the brain. The environment where one lives and
grows, and the exchanges that take place with people in the
environment shape the capacities that emerge in the early
years.

In the very first few weeks and months of life,
milestones can be seen that reinforce the construct of brain
architecture. A newborn does not immediately have neck
control, but a newborn's head gradually wobbles less in the weeks
after birth. One of the best times to observe this is during
tummy time. A newborn will also become responsive to sounds,
especially their mother's or caregiver's voice. They will
become drawn to the voice and respond by focusing in the direction
of the sound. A newborn can also communicate by being quiet,
cooing or babbling, and reaching.

The postnatal period is a critical time for newborn babies and
mothers and many changes occur during this period. Although manuals
are helpful, they are not provided at discharge from the hospital,
and the web is overloaded with information that can easily
overwhelm new parents. The pediatric provider is the filter
and support system a family needs to navigate through information
they'll receive to care for their newborn. Lack of
appropriate care during this time can result in significant issues
lasting into adulthood. Newborns and mothers should be
assessed at regular intervals following delivery. Further
evaluation can be achieved through referrals from the healthcare
provider as needed. The
American Academy of Pediatrics has developed a periodicity
schedule that providers can follow to assess the health of the
newborn, and the health and emotional well-being of the
mother.

The newborn
checkup is an important medical visit for the provider to
assess the health and development of the newborn following
discharge from the hospital. This initial visit with the
healthcare provider allows the family to begin building a
relationship with the provider and the medical home as important
resources for them and their child - a partnership that lasts
throughout the life of the child. Although the newborn
checkup is for the new patient, it is equally important to focus on
how the entire family is adjusting to the new addition to the
family. This visit sets the expectation for the
two-generational relationship that is created, and includes asking
questions, addressing concerns, and providing parent education and
anticipatory guidance.

Providers spend time educating and giving
anticipatory guidance to parents. It has been found
that books effectively increase maternal knowledge
of anticipatory guidance material and encourage social and
emotional bonding between parents and babies. During
well-child visits, parents are educated on many topics, and are
likely to recall less of the information as more topics are
covered. Given the brevity of pediatric visits, providers can
target behaviors like reading, talking, singing, cuddling, and
bonding that are important. Embedding Reach Out and Read in the standard of
medical care offers additional opportunities to encourage
parent-infant reading, which influences parent-child interactions,
children's language development, and future reading
ability. The value of the intervention has been
shown in lower maternal depression scores, and reports of maternal
enjoyment of reading, and time spent reading with their
children. This is significant because the AAP supports
maternal depression screenings per "Incorporating Recognition and Management of
Perinatal and Postpartum Depression Into Pediatric Practice,"
beginning at the one-month well-child visit.

The research supports the value of starting Reach Out and Read
in infancy. Through this early literacy intervention,
providers can support parents and impact children's lives from the
beginning. Here in Reach Out and Read Carolinas, we are
joining with a National Reach Out and Read initiative to align with
science and incorporate a zero to 6-month component of the Reach
Out and Read program, encouraging our providers to talk with the
pediatric patient and family about the importance of engaging with
infants and sharing books in the first few months. Research
on the impact of this early intervention will continue to inform
and guide our rollout across the country.

Thursday January 26, 2017

Reach Out and Read partners, Nemours BrightStart! have
released the 2nd Annual Reading Readiness Snapshot for America's
Preschoolers - a guest blog post from Laura Bailet and Kathy
Ingram at Nemours BrightStart!

Learning to read is a challenging task for the
brain, and one of the most important developmental tasks facing
young children. Only about a third of U. S. students score as
'proficient' readers (Nation's Report Card, 2016). In response to
overwhelming evidence that the foundation for successful reading is
built in the early years, when a young child's brain is highly
responsive, adaptable and attuned to learning language, the Nemours
Children's Health System has created
Nemours BrightStart to research, develop and offer
evidence-based tools targeting young children at risk for reading
failure. One of our tools, the Nemours
online Preschool Reading Screener, is an effective, free
screener that is widely available and easy to complete, to identify
children in need of assistance early.

For children between birth and five years, developmental
screening is often the domain of pediatricians, as part of routine
developmental surveillance (Halfon et al., 2004). However,
even with well-established guidelines and reliable tools, nearly
half of all children fail to receive recommended screening (Halfon
et al., 2004; Sand et al., 2005). For children with subtle
developmental problems, such as reading readiness delays, 70
percent or more may go undetected (Glascoe, 2000) with the current
system. Part of the challenge is time constraints for the
pediatrician, and lack of an easy and effective screening tool.

Parents often play a central role in developmental screenings of
their children. Research shows that, if questions are clearly
stated, they are able to respond accurately (Dewey, Crawford, &
Kaplan, 2003; Fenson et al., 1994; Glascoe, 2000). Studies
also show that parental self-efficacy and parenting competence are
positively correlated when parenting knowledge is high (Bornstein
et al., 2010). Yet parents' specific knowledge of key normal
developmental indicators and milestones in the preschool years is
low (Bornstein et al., 2010).

Completion of a straightforward screener thus may
serve simultaneously to increase parents' knowledge, promote
greater intentionality with early literacy activities at home, and
improve future reading outcomes. The Nemours'
Preschool Reading Screener is designed for
this purpose. It contains 31 questions organized into key
reading readiness skills including oral language, letter knowledge,
phonological awareness, and beginning writing. Parents
receive a rating of their child's skill levels and an action plan.
Thousands of parents of 3-, 4- and 5-year old children have
completed the screener and a summary of their results can be found
in the 2nd Annual
Reading Readiness Snapshot for America's Preschoolers released
this week. The Snapshot reports:

Out of a maximum possible 31 points, the average score for
3-year olds is 18; for 4-year olds, 23; and for 5-year olds,
26. Not surprising, 3-year olds earn most of their points on
oral language items and also have some beginning knowledge of
rhyming and beginning sounds. For 4-year olds, the emergence
of letter knowledge is especially striking; nearly 68% of them are
able to identify at least 18 upper case letters, a skill that is
vital for being on track for reading success as they move into
kindergarten. More than 90% of 5-year olds demonstrate strong
letter naming skills, and skill with letter sounds and with rhyming
are also strong. Blending words is easier for 5-year olds
than breaking them apart.

The Snapshot shows how preschoolers are actually doing in
reading readiness, according to the people who know them best:
their parents. With reasonable efforts to expose young
children to books, language, drawing and writing, they will develop
a solid foundation for future reading success. Screening for
early literacy skills can be empowering and motivating for parents;
they want to know early if their child is on track with reading
readiness skills, or may need increased home literacy activities
and book reading opportunities. It also helps parents
understand connections between oral language, reading and writing,
which in turn helps them offer a broader array of experiences,
woven into their daily routines, that ultimately support reading
development.

Wednesday June 15, 2016

A guest blog from Dr. Dipesh Navsaria, a U.S. pediatrician
who participates in the national early literacy program Reach Out and Read and
understands the importance of reading aloud to children of all
ages.

After recognizing that reading to your child is one of the first
brain-building activities to start routinely doing with your child,
the next question is: which book? Not all children's books
are created the same: some are not very good at all, and others are
mere vehicles for marketing to you and your children. Yet the
array of choices available at any public library or bookstore can
be dizzying and bewildering. How to choose?

When it comes to finding good books, your best bet is to make
use of your expert local resources: your public librarian is
usually well-versed in high-quality children's books for a variety
of ages, cultures and interests. They are more than happy to
field your enquiries; not only can they recommend books in their
collection, they can obtain books for you via interlibrary loan or
even purchase them based on your requests!

If you're looking to select books yourself, the most important
question to ask is: "Does the book interest you?" If the
adult reading the book finds it interesting and engaging, there's a
high likelihood the baby or child will as well. Also, if the
reader truly enjoys the book, he or she is more likely to read it
with the kind of enthusiasm and expression that will in turn engage
the baby or child listener.

Next, look at the images in the book; are they interesting and
engaging? This may range from beautiful artwork to complex
images inviting the reader to linger over them to things inherently
interesting to young children (e.g. baby faces, animals,
etc). As a child becomes older (after about age 2 years),
does the text connect to images in a way that encourages
language? For example, does reading the story reference items
in the images like colors or other features that build vocabulary
and help a child develop skills in naming?

For some families, it can be important to find at least a few
books in which the children look somewhat like themselves,
celebrate similar holidays, speak the same languages, or eat
similar foods. I remember the joy with which my son pointed
to a photograph of a little girl in a book of nursery rhymes and
said it looked like his sister. This is not a requirement,
but children do deserve and delight to see other children with some
aspects of their lives similar to their own.

Developmentally speaking, is the book's format
appropriate? Board books are designed for young children who
do not yet have a "pincer" grasp developed - that pincer grasp is
necessary to turn paper pages.

Finally, while these are good general principles to keep in
mind, one never knows what books will take hold of a child's
interest. Sometimes the most unlikely-seeming choices will
enrapture-and that's absolutely fine!

"We are not wise enough, we adults, to know what books will be
right for any child at any particular moment, but the richer the
book, the more imaginative, the more emotionally true, the more
beautiful the language, the better the chance it will minister to a
child's deep inarticulate fears."

- Katherine Paterson, writing in The Horn Book, Jan/Feb
1991

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